Early-stage gallbladder cancer in the surveillance, epidemiology, and end results database: Effect of extended surgical resection

Abstract

Hypothesis: Extended surgical resection (ESR) may improve survival in patients with early-stage primary gallbladder cancer. Design: Retrospective analysis of findings in the Surveillance, Epidemiology, and End Results (SEER) database. Setting: Academic research. Patients: Individuals with potentially surgically curable gallbladder cancer (Tis, T1, or T2) who underwent a surgical procedure. Main Outcome Measures: Overall survival, number of lymph nodes (LNs) excised, and results of simple cholecystectomy vs ESR. Results:Weidentified 3209 patients with early-stage gallbladder cancer (11.7% Tis, 30.1% T1, and 58.2% T2). On multivariate analysis, decreased survival was noted among patients older than 60 years (hazard ratio, 1.57; 95% confidence interval, 1.30-1.90), among patients with more advanced cancer (1.99; 1.46-2.70 for T1; 3.29; 2.45-4.43 for T2), and among patients with disease-positive LNs (1.65; 1.39-1.95 for regional; 2.58; 1.54-4.34 for distant) (P